Criminal law and the proceedings surrounding it work, at least in theory, much like an author works when writing a play or a novel. Both the lawyer and the writer follow traditional formulae that allow them to create and express a vision of reality. When done well, the reality created is virtually seamless. This, however, is the point at which law and literary works diverge. Although we embrace creativity in literary endeavors, we would prefer that the foundation of our legal (...) system be something more substantial. Unfortunately, where US. criminal HIV exposure statutes are concerned, there appears to be little if any concrete connection between proscribed behaviors and what we know about HIV transmission risk. Twenty-four states in the U.S. make it a criminal offense for a person who has HIV to expose another to the virus through consensual sexual activities. The relationship between the activities prohibited by these laws and actual risk of virus transmission is tenuous at best. (shrink)

Criminal law and the proceedings surrounding it work, at least in theory, much like an author works when writing a play or a novel. Both the lawyer and the writer follow traditional formulae that allow them to create and express a vision of reality. When done well, the reality created is virtually seamless. This, however, is the point at which law and literary works diverge. Although we embrace creativity in literary endeavors, we would prefer that the foundation of our legal (...) system be something more substantial. Unfortunately, where US. criminal HIV exposure statutes are concerned, there appears to be little if any concrete connection between proscribed behaviors and what we know about HIV transmission risk. Twenty-four states in the U.S. make it a criminal offense for a person who has HIV to expose another to the virus through consensual sexual activities. The relationship between the activities prohibited by these laws and actual risk of virus transmission is tenuous at best. (shrink)

Twenty-four U.S. states have enacted HIV exposure laws that prohibit HIV-positive persons from engaging in sexual activities with partners to whom they have not disclosed their HIV status. There is little standardization among existing HIV exposure laws, which vary substantially with respect to the sexual activities that are prohibited without prior serostatus disclosure. Logical analysis and mathematical modeling were used to explore the HIV prevention effectiveness of two types of HIV exposure laws: “strict” laws that require HIV-positive persons to disclose (...) their serostatus to prospective partners prior to any sexual activity and “flexible” laws that require seropositive status disclosure only prior to high-risk sex . These laws were compared relative to each other and to a no-law alternative. The results of these analyses indicate that, under most circumstances, both strict and flexible exposure laws can be expected to reduce HIV transmission risk relative to the no-law alternative, with flexible exposure laws producing the greater reduction in risk. This study demonstrates how logical analysis and mathematical modeling techniques can make an important contribution to the construction of a rational basis for decisions about a highly contested public health policy issue. (shrink)

Twenty-four U.S. states have enacted HIV exposure laws that prohibit HIV-positive persons from engaging in sexual activities with partners to whom they have not disclosed their HIV-status. From a public health perspective, HIV serostatus exposure laws can be viewed as structural interventions that seek to limit the spread of HIV by acting at the policy level. A central premise of these laws is that informed partners are more likely to protect themselves by declining sex, by substituting less risky activities for (...) higher-risk ones, or by using condoms, than are uninformed partners. However, the effectiveness of these laws at preventing HIV transmission is not known.There is little standardization among existing HIV exposure laws, which vary substantially with respect to the sexual activities that are prohibited without prior serostatus disclosure. Among the strictest laws are those in Arkansas, Michigan, New Jersey, and Ohio which mandate disclosure prior to almost any type of sexual contact. (shrink)